W.Va. Autism Insurance "Fix" Hits 11th-Hour Snag

By: Cathleen Moxley, The Associated Press Email
By: Cathleen Moxley, The Associated Press Email

UPDATE 3/6/12 @ 8:00 a.m.
CHARLESTON, W.Va. (AP) -- An attempt to revisit West Virginia's new autism insurance coverage law may be in trouble.

The legislation is slated for a final Senate vote on Wednesday. But Senate Finance Chairman Roman Prezioso says he's been asked to seek a last-minute fiscal analysis of the bill.

Bill supporters fear this is an attempt to derail the measure.

Legislators reviewed the potential costs before passing the new law last year. This fiscal analysis specifically looked at benefit caps on applied behavioral analysis.

Experts consider ABA treatment crucial for many children diagnosed with autism spectrum disorders.

Advocates for these children have sought ABA insurance coverage for years. The pending bill would make clear that the new law's benefit caps apply to ABA treatment.

Insurers want the caps to apply to all autism-related coverage.



CHARLESTON, W.Va. (WSAZ) -- In many ways, Jonah Hercules is just like any 6-year-old child. However, it's his battle with autism that he and his father, Jay Hercules, struggle with every day.

“He doesn't understand danger. He doesn't understand that things can hurt him,” Jay Hercules said.

The biggest pain now can be found in his wallet. Applied behavior analysis (ABA) is a treatment that costs $30,000 to $50,000 a year.
Experts say it's the best thing for any child with autism.

“It's intensive teaching. You need a one to one teacher who's well trained,” Susannah Poe, who diagnoses children with autism, said.

Legislation passed last year was meant to help, providing a $30,000 annual cap for the first three years of treatment. But the wording got mixed up -- giving some insurance companies the idea that it goes for all types of therapy.

That means many parents wouldn't be able to afford everything their children need.

“We're already a very large amount in debt,” Jay Hercules said. “The price that some people would pay for a house.”

Lawmakers are now working to clean up the mistake before the session is over.

“I think the reason people are here is because we're worried. It was a very big fight last year,” Delegate Barbara Fleischauer, (D) Monongalia, said.

“Fixing the legislation will be as much of a relief as the initial passage of the legislation,” Jay Hercules said.

The bill is currently in the House Finance Committee. It still needs to be approved on the floor and sent over to the Senate.


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